3. Costs of environmental illness: All diseases: 76.6 billion Lead poisoning: $50.9 billion Autism: $7.9 billion Intellectual disability: $5.4 billion Exposure to mercury (methyl mercury): $5.1 billion Attention deficit hyperactivity disorder: $5.0 billion Asthma: $2.2billion Childhood cancer cost: $95.0 million 3.5% of health care expenditures Source: Trasande L, Liu Y. Reducing the staggering costs of environmental disease in children. Health Aff. 2011 May;30(5):863-70.
4. Health consequences of inadequate housing are substantial. Indoor dampness/mold Home injury Crowding Indoor cold Traffic noise Second-hand smoke Radon Lead CO Formaldehyde Indoor smoke from solid fuel Housing quality www.euro.who.int/__data/assets/pdf_file/0003/142077/e95004.pdf
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6. Benefits of Housing Upgrades Environmental health Vaccines For every $1 spent there is a benefit of $5.30-$16.50 For every $1 spent to reduce lead hazards there is a benefit of $17-$220 For every $1 spent on asthma interventions there is a benefit of $36.
7. Green and Healthy Renovationof Affordable Housing Source: Public Health Reports / 2011 Supplement 1 / Volume 126
8. Common Green and Healthy Rehab Elements Low-VOC adhesives, paints & coatings Ventilation: ASHRAE 62.2 Integrated pest management No carpet in wet areas Energy Star fans exhausted to exterior
16. ‘‘Livable Communities Act of 2011’’ Introduced by Senator Robert Menendez(D-NJ) Promotes livable communities through sustainable infrastructure for transportation, affordable housing, healthy housing, land use and economic development Authorizes the HUD Office of Sustainable Housing and Communities Authorizes Regional Planning and Community Challenge grants Adds a new Healthy Homes section
17. Tools for Incorporating Health into Housing and Community Development EPA Indoor Environment Protocols Healthy Development Measurement Tool Health Impact Assessment
18. Intended for voluntary adoption by: Weatherization assistance programs, Federally funded housing programs Private sector home performance contracting organizations Others working on residential retrofit or remodeling efforts www.epa.gov/iaq/pdfs/epa_retrofit_protocols_draft_110910.pdf
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20. Healthy Development Measurement Tool 100+ community-level measures Menus of policy and best practices Criteria for development projects Supporting public health evidence www.thehdmt.org Source: San Francisco Department of Public Health
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22. Health Impact Assessment A combination of procedures, methods and tools that systematically judges the potential, and sometimes unintended, effects of a policy, plan, program or project on the health of a population and the distribution of those effects within the population. A Health Impact Assessment Toolkit: www.humanimpact.org
26. Conclusion Housing related disease and injuries are costly The return on investment for building healthier homes and communities is considerable Practical tools are available to housing and community development professionals to make communities more livable, healthy and sustainable.
27. “For many years, I have lived uncomfortably with the belief that most planning and architectural design suffers for lack of real and basic purpose. The ultimate purpose, it seems to me, must be the improvement of mankind.”--- Jim Rouse
28. Rebecca Morley National Center for Healthy Housing in Columbia, MD and Washington DC rmorley@nchh.org www.nchh.org (t) 443.539.4159
Editor's Notes
Thank you for inviting me to present a summary overview of existing codes and guidelines in four countries, the United States, England, New Zealand and France, that are both voluntary and required in statutes and/or regulations. Given time and space limitations, this summary will not be exhaustive, but instead focus on the major national programs and policies in these countries.We’ll first review the codes and guidelines advanced since the 1800s and then cover codes and guidelines adopted or promoted in the US, England, New Zealand and France over the last 10 to 20 years. Lastly, we’ll briefly discuss policy gaps and barriers that need to be overcome in order to achieve the widespread adoption of codes, guidelines and housing standards.
Poor childhood health caused by environmental factors, such as air pollution and exposure to toxic chemicals, costs theUnited States $76.6 billion in 2008, according to authors of a new study in the May issue of Health Affairs. This price tag represents a dramatic increase in recent years, rising from 2.8 percent of total health care costs in 1997 to 3.5 percent in 2008. The new study by Leonardo Trasande of the Mount Sinai School of Medicine focused on the cost of lead poisoning, childhood cancer and chronic conditions, including asthma, intellectual disability, autism and attention deficit disorder--conditions that are linked to environmental toxins and pollutants in the air, food, water, and soil, as well as in homes and neighborhoods. Researchers used recent data to estimate the number of environmentally induced conditions in children and then calculated the annual cost for direct medicalcare and indirect costs, such as lost productivity resulting from parents‘ caring for sick children. They found that the aggregate cost of environmental illness in children was $76.6 billion in 2008 dollars. The study provides an update to an analysis of 1997 data that documented $54.9 billion in annual costs of environmentally contributable childhood diseases in the United States. In comparing the two studies, researchers found that diminished exposure to lead and reductions in costs for asthma care were offset by diseases newly identified as environmentallyinduced, including attention deficit disorder, and the added burden of mercury exposure. This toxic metal, from contaminated fish and coal-fired power plants, can harm the developing brain and is associated withintellectual disability. Key findings from the study: Lead poisoning cost $50.9 > billion Autism cost $7.9 billion Intellectual disability cost $5.4 > billion Exposure to mercury (methyl mercury) cost $5.1 billionAttention > deficit hyperactivity disorder cost $5.0 billion Asthma cost $2.2billion > Childhood cancer cost $95.0 million
Summary: The report provides evidence that the health consequencesof inadequate housing are substantial. Improvinghousing in a way that removes or at least minimizes thenegative impact on health and safety and promotes ahealthier living environment is good for the residentsand beneficial for society. Reducing the burden ofresponding to the demands on the health systemattributable to inadequate housing should therefore beseen as an obvious public health priority, but also assomething that makes economic sense.
For example, for every $1 spent to reduce lead hazards there is a benefit of $17-220 and for every $1 spent on asthma interventions there is a benefit of $36. These ratios are better than that for vaccines ($5.30-16.50 savings per $1 spent), which have long been described as the single most cost-beneficial medical or public health intervention.
Authorizes the HUD Office of Sustainable Housing and Communities;Maintains Regional Planning and Community Challenge grants;Eliminates the Interagency Council (old Sec. 6);Eliminates the Regeneration planning grant demonstration program (old Sec. 9);Adds a new Healthy Homes section. Tasks HUD to lead an interagency effort to evaluate, coordinate, and make recommendations to refine and improve healthy housing policy effectiveness across relevant agencies. This aligns with existing efforts in HUD’s Healthy Homes Strategic Plan;Retains the Study and Report on Sustainable Building Features and Indoor Environmental Quality;Expands T&H Affordability Index Report to call for the creation of a publicly available index and production of case studies on the application of the index to existing HUD programs and policies (in line w/ HUD’s recent announcement); Keeps the TOD loan program; andKeeps the rural set-asides.